Incident report

Weather Conditions: Sunny, Calm Breeze, and High 80”s to Low 90’s Statement by John Lojacono, Park Ranger Guana State Park, Ponte Vedra Beach Fiordia While I was patroling the Dam Use Area of Guana State Park, I was flagged down by 4-5 Fishermen, whom were in a group. They told me that a woman was having a seizure at the Dam. I proceeded to the area where I observed an Asian woman sitting up in a chair with an Asian man standing next to the chair supporting her. When I approached the front of the woman, 1 observed that she was unconscience with her eyes closed and had a bubbly fluid coming out of her nose and mouth. Her facial conplexion looked to be a normal color. I asked the man, who I thought was her husband, “What had happened?” And he replied “that she had passed out or fainted.” Then he stated “that she had taken some medication” and pulled out of his shirt pocket an individually wrapped pill packet that had writing on it that said Penicillin and some numbers (which I can not remember that numbers they were). I asked the man “why she took the medicine?” And he responded but 1 could not understand his broken english. 1 grabbed the woman’s shoulder and sqeezed her shoulder and asked “Marne can you hear me?” And got no response, then 1 grabbed her left hand and asked her to squeeze my hand and got no response. After there was no response, I checked for a pulse on the left side of her neck with two fingers and felt a weak pulse, I observed bubbles coming out of her nose, which indicated some flow of oxygen. I ran to my vehicle to call for 911, while running to vehicle, I told the fishermen that I was calling 911, at that time 2 of the fishermen told me that they had already called 911. I then asked them “you called 911 already?” And they replied “yes, we have already called 911 on our cell phone.” 1 ran back to the woman still sitting up right in the chair while being supported by the man. I advised the man that we needed to lay the woman down on the ground. He asked me to go get a blanket from her car to lay her on and he gave me the keys to her care. Sense she had a pulse and was moving oxygen, I ran to the woman’s car, unlocked the passenger car door, took out the key, opened the door, reached into the back seat to grab the blanket, closed the passenger door, but did not lock it. Then I ran back to the victom, layed the blanket on the ground and laid the keys on the ground. I said to the man “ let’s move her to the ground”, the man and myself then reached under her arm pit and under her knee cap, each on one side of her and lifted her up off the chair and placed her on the ground on her right side. I placed her on her side incase she began to vomit, she would not choke. The man then sat crossed legged at her head and placed her head on his calf to support her head, at a level position. At this point, I again checked for a pulse, which was weak. Within a minute of laying the woman on the ground, the first responder arrived, Vicky. She asked “what was going on down here?” 1 told her “that she might have had a reaction to penicillin”. Vicky then rolled her onto her back. The man moved out of the way for us to check the woman. Vicky then checked the woman and then stated “1 think she just crashed and that we need to perform CPR.” Vicky asked me “if I knew CPR?“ 1 answered “yes” and then she asked me if 1 wanted to do compressions or administer the oxygen?” I replied “I’d do the oxygen”. At that time 2 more responders arrived. Vicky then shouted ‘That we need to do CPR” to the other responders as they were getting out of their cars. Vicky then radioed the dispatcher with her hand held radio that we needed EMS. They replied that the unit was 2 miles south of Micklers and was on the way. At this time the 2 other responders were getting equiment out Vicky’s bag. Vicky then got the bag valve mask out and other epuipment ready while the other responder lady assisted. The man responder observed. At this point I was at the woman’s head and tilted it back to open her airway, Vicky placed the bag valve mask on the woman face. I then held down the mask with my left hand while tring to maintain an opened airway and squoze the bulb with my right hand. J was having difficultly with securing the mask since it did not havp a strap on it. 1 had to hold her head in a tilted position and hold the mask down with my left hand at the same time, with no assistance. At this point I retilted the head but was still not getting any air to pass to the lungs. I retilted the head numerous times but was unable to get air to pass to the lungs. At this time Vicky was doing chest compressions. We did 3 cycles of CPR (5 to 2). The woman began to vomit; we rolled her onto her right side, while I was held her head. Chunks of rice and fluid came out of her mouth. When she stopped vomitting, I did a mouth sweep with my left index finger and located nothing in the mouth. We then rolled her over onto her back again. I tilted the woman’s head and put the Bag Valve Mask back on her face and I began oxygen admistration again. At this point Vicky unbuttoned the womans shirt and put the AED pads on her chest. Turned on the AED and the machine told us to “Stand Clear” and Vicky told me to “Stand Clear”. The machine advised us “NO shock advised”. Then we begin CPR again. The woman began to vomit again, so we rolled her back onto her right side, while 1 held her head. Once she stopped vomitting, I again did a finger sweep with my left index finger and again found no obstruction. We then rolled her back onto her back, I retilted her head and the second responder lady suctioned out the woman’s mouth and once again we began CPR cycles. EMS arrived; they set up their equipement and put on their EKG machine, f advised EMS that we were unable to get air to pass to the woman’s lungs. EMS then suctioned out the woman’s mouth with their machine. At this point I moved out of the way. As EMS worked on the woman, I walked down to the water, just a few steps to rinse off my hand from doing the finger sweep without gloves. I then walked back to the woman and observed EMS as they worked on the woman. Date signed John Lojacono, Park Ranger